Noninsured Crop Disaster Assistance Program (NAP) and Report of Acreage

OS/29/2008

12:23

FAX

!41 002

2027205233
Form Appr~ved

FSA-578 (Producer

Print)

. OMB

No. 0560-0004

PROGRAM YEAR 2005

,REPORT OF ACREAGE

DATE: 04-15-2005
Produ~er
OAV IO

~

NOTE:

Nam~

10

and Addr~~s

I

\
The following
stat~ments
ar@ made in atcordance with the Privacy Act of 1974(5 USC 552a). Th@ Agricultural
Adjustment
Act
of 1938. ~s amend~d. and the Agricultural
Att of 1949, as amended. authori~ed the ~ollection
of the following
data. The
data will be used to determine eligibility
for assistance. furnishing
the data is voluntary,
however, Without it assistant~

cannot

he nrovlded

The d~~a

may

h~ furnl~hed

to any aqencv

resoonSl0le

for @nfortlno

the provl~lons

of the Acts

Public reporting burden for this collection
of information is Qstimat~d to averageLlS minutes per response, IncludIng
the time
for r@vlewing in~tructlon~,
searchIng existing data sources, gathering and maintaining
the data needed. and completing
and
revl@wlng
the collection
of information.
Send comments regardIng this burden estimate. or any other aspect of this collettion
of
InformatIon,
W~shington.
Washinaton
Farm,
Number

Including ~uggestlons
for r@duCing this bvrden. to the Department
of Agricultur@.
Cle~rince
Off1cer, AS Box 7630.
D.C. 20250: and to the Off1ce of Management ana Budget. paperwork R@ductlon Project (OMB No. OS60-0004).
D.C
20503.
RETURN THIS COHPLET~D FORM TO YOUR FSA COUNTY OFFIC£.

Tract
Number

5173
Photo

CLU/
fIeld

Ir
Pr

Gfe

Var/
Type

1

Ni

WHEAT

~RW

Number/Legal

0.0

Cropland:

C/C
Type
WHEAT HRW

PRODUCER'S

Prac
N

IU
GR

R@ported
5.00

C[RTI~ICATION:

Prod
Share

Prod
Name

10-04-2004

1.0000

IJAVIO

C/C

Gratn

5.00

A

5173

Description:

Planting
Date

Rpt Reported O@termlned
Stat Unit Quantity
Quantity

lot
Use

Farmland:

RMA

WZNESW

86.0

DetermIned

I certify

to the

best of my knowledge

and belief

that

the acreage

of crops

and

land uses

listed

herein are true and correct. and that all reqUired crODS and land uses have been reDort~d for the far~ as applIcable,
SIgning of this form g1ves FSA representatives
authorization
to enter and inspect crops and land U~es on the above
identified
land
Produc@r's

Signature

jDate

____
This program
or19in
sex

Opt

Unit IJnlt

Or actiVIty wfll be conducted on a nondiscrfmlnatory
ace. marital status. or dl~abilltv.

basis

wIthout

regard

I

n-1

to race,

color,

religion,

n~tional

The

umber/Legal

141

05/29/2008

12:23 FAX

REPORT OF COMMODITIES

PROGRAM YEAR 2005

FARM AND TRACT DETAIL LISTING

DATE: 04-15-2005

FSA-578(02-01-91)

FARM NUMBER:
Operator

Name an~ Address

003

2027205233

3000
lD

Orlg1nal:

_

Il.evhltm:
: ; (H .;..•••.
""••.:: ~._

Use
10
H1
Int
5.00
.0
5.00
Unit
Use
Unit
WHEAT
Stat
Grain
Pre
Prod
NVar/
'"cl
AD.E.F.6.H.J.K.L,M.N.O.P,R:
I
Lnd
01f1erenr;e;
RMA
HRW
Prod
Share
5.00
5.00
tIC
CIC
Irr
Determ1ned
CUJI
1Flel
0/
Reportecl
Quanta)'
Quantity
Type
OPt
1.0000
prat:
Irrioated
IV
Non-Irrig
Reporte~
TractGR
Reported;
Rpt
Type
CrOPland:
Description:

.00

W2"ESW;~

PAGE

1

Cropland:

0.0

Farmland:

86.0

~004
OS/29/2008

12:24

FAX 2027205233

D DIVIOE. "O~,~ OA~01A

FSA-578(02-01-91)

FARM NUMBER:
Operator

Name

and

REPORT

3000

Address

PROGRAM YEAR 2005

OF COMMODITIES

DATE:

FARM SUMMARY
10

04-15-2005

OrIgInal:
RevIsion:

I~'" •••••.•••.•
-

NOTE:

Cropland;

0.0

Farmland:

86.0

The authorIty
for colle~tlng the folloWIng Information
IS Pub.~ 107-76.
ThiS authority allows for the collection
of
Information
without prior OMS approval mandated by the Paperwork R@ductlon Act of 1995.
The data will be used to
for assistance.
Furnishing
the data is voluntary. however. without It assistance
cannot be
determIne
eligibility
orovlded.

Produ~er

The

data mav

~e furnl~hed

10

Name

to any aoencv

C1C
WHEAT

Cro~ Type Prac
WHEAT HRW
N

IU
GR

r~File Typeapplication/pdfFile Modified2008-06-11File Created2008-06-11